Scientific Drought, Golden Eggs, and Global Leadership – Why Trump’s NIH Funding Cuts Would Be a Disaster – This New England Journal of Medicine Perspective piece unpacks the most significant cut ever proposed by a U.S. president to the National Institutes of Health, and the impacts it would have on American leadership in science, the development of new medicines, job creation, and pharmaceutical profits, with impacts on local, national and global economies. It also highlights the administration’s proposal to end funding for the Agency for Healthcare Research and Quality, which, the authors write, has contributed through its research to saving an estimated 125,000 lives in recent years, and the proposal to eliminate the Fogarty International Center, which through global collaborations, maximizes the value of other investments and builds a foundation for outbreak preparedness.

The Real Threat to National Security: Deadly Disease – If the flu epidemic of 1918 killed more people than the overlapping — and four-times longer — outbreak known then as “the Great War,” just think of what an airborne outbreak could do in today’s more connected world. This is one of the arguments the authors, one of whom, Michael Osterholm – an epidemiologist and infectious disease research and policy center director – make, raising the threats posed by clear and current dangers, including antibiotic-resistant pathogens, yellow fever, Middle East Respiratory Syndrome, and Ebola. They argue that preparedness to counter infectious diseases “is where ‘defense spending’ needs to increase, significantly.”

Priorities for Public Health Spending – The letter here by Sean Cahill, Dr. Kenneth Mayer, and Dr. Stephen Boswell of Boston’s Fenway Institute takes issue with a recent JAMA editorial in which oncologist and bioethicist Ezekiel Emanuel argued that public health spending on HIV services was disproportionately high (Emanuel had supported his point by noting the virus was reported the year before as the cause of death for “only” 6721 U.S. residents). Cahill et al note that greater resources are important to respond to all critical health concerns, and that the prioritization that Dr. Emanuel encourages is ill-advised. “Reducing funding for a communicable disease affecting more than 1 million individuals in the United States will lead to problems in the future,” they note, spelling out the problems that can be expected when a virus that is incurable but can be suppressed by treatment is allowed, instead, to continue to spread. Also describing the gains that funding HIV research and services have led to, they argue that “costs related to HIV, tuberculosis, and all other causes of morbidity and mortality should be evaluated on their own merits.” In turn, Emanuel responds, below the letter, using the term “opportunity costs” three times, and calling the authors “irresponsible” for seeming “to imply that resource limits do not exist.”

NIH and the bodies politic – This piece from 20 years ago takes us back to another time when “resource limits” prompted an examination of the returns on scientific investments. It includes an even earlier observation from President Franklin Delano Roosevelt even as the nation straddled the Great Depression and World War II: “We cannot be a strong nation unless we are a healthy nation.”